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Öğe Evaluation of the readability of informed consent forms used in urology: Is there a difference between open, endoscopic, and laparoscopic surgery?(2018) Sönmez, Mehmet Giray; Öztürk, Ahmet; Özkent, Mehmet Serkan; Ecer, Gökhan; Boğa, Mehmet Salih; Demirelli, Erhan; Kozanhan, BetülObjective: The aim of this study is to evaluate the readability levels of informed consent forms used in Turkey before urological surgery and to compare the readability levels of open, endoscopic, and laparoscopic surgical informed consent forms. Material and Methods: A total of 529 informed consent forms used for urological open, endoscopic, and laparoscopic surgical procedures were collected from different hospitals in Turkey. Evaluating informed consent forms that have exactly the same text only once, a total of 69 consent forms were evaluated. The Gunning Fog Index and Flesch–Kincaid test measuring the general readability level were used to calculate the readability level of informed consent forms in addition to the Ateşman and Bezirci–Yılmaz formulas defined to determine the readability level of Turkish texts. Informed consent forms were evaluated and divided into three groups as open, endoscopic, and laparoscopic surgery forms, depending on their content. Results: Among 69 informed consent forms evaluated, 35 were open, 19 were endoscopic, and 15 were laparoscopicsurgery consent forms. The readability level of all informed consent forms was detected as average according to theAteşman formula, very difficult according to the Flesch–Kincaid test, difficult according to the Gunning Fog Index, and at the high school education level according to the Bezirci–Yılmaz formula. A statistical evaluation of the three groups did not show a significant difference in the readability level. Conclusion: In this study, it was detected that the informed consent form readability levels used for urological surgical procedures in our country were rather low. We think that the cooperation of the concerned institutions is required for the revisionof the consent information texts available and the improvement of the texts according to the strategies recommended.Öğe Influencing factors of acute kidney injury following retrograde intrarenal surgery(Springer, 2023) Göger, Yunus Emre; Özkent, Mehmet Serkan; Kılınç, Muzaffer Tansel; Erol, Eren; Taşkapu, Hakan HakkıPurpose: To investigate the influencing factors of acute kidney injury (AKI) following retrograde intrarenal surgery (RIRS). Methods: The data of patients who underwent RIRS for kidney stones between January 2018 and June 2022 at two tertiary centers were retrospectively analyzed. Demographic data of patients were obtained. According to kidney disease: Improving Global Outcomes (KDIGO) criteria, those with and without AKI were divided into two groups. Preoperative, intraoperative, and postoperative predictive factors of patients were investigated between the groups. In addition, the influencing factors of AKI were examined by multivariate analysis. Results: This study included 295 (35.7%) women and 532 (64.3%) men. The mean age was 50.03 +/- 15.4 years (range 18-89), and mean stone size was 15.5 +/- 6.1 mm (range 6-47). Overall, 672 of patients (81.3%) were stone-free after the initial treatment. According to KDIGO, 110 of patients (13.3%) had AKI during the postoperative period. Univariate analysis showed that stone size (P=.003), previous stone surgery (P=.010), renal malformations (P=.017), high operative time (P=<.001), high preoperative creatinine value (P=.036), intraoperative complications (P=.018), and postoperative urinary tract infection (P=.003) had significant influence on the AKI after RIRS. Multivariate analysis excluded previous stone surgery, high preoperative creatinine value, renal malformations, and intraoperative complications from the logistic regression model, whereas other factors maintained their statistically significant effect on AKI, indicating that they were independent predictors. Conclusions: Stone size, operative time, postoperative urinary tract infection, and diabetes mellitus are significant predictors of AKI. During RIRS, urologists should consider the factors that increase the risk of AKI and evaluate the treatment outcomes based on these factors.Öğe New surgical technique applied with urological instruments in bilobar multiple hepatolithiasis: Ultra-mini percutaneous hepatolithotomy(2017) Öztürk, Ahmet; Sönmez, Mehmet Giray; Bakdık, Süleyman; Göğer, Yunus Emre; Özkent, Mehmet Serkan; Aksoy, Faruk; Belviranlı, MetinIntrahepatic bile duct stones may emerge with manifestations as chronic stomach ache, cholestasis, cholangitis, abscess, post-obstructive atrophy and liver cirrhosis presentation may occur. Thus the treatment of symptomatic hepatolithiasis patients should be provided. Different methods such as biliary decompression, endoscopic, percutaneous or open surgery are recommended for the treatment of patients with intrahepatic gallstones. The aim of the treatment is to extract the stones and regain biliary drainage. But the treatment regimen to be applied should be determined after examining the age, performance condition, general conditionof the patient and location of the stone carefully. In this case, we presented a young female patient whohad many unsuccessful surgical interventions due to coledochal cyst and congenital malformation in bileducts, had large stones in right and left intrahepatic bile ducts and in whom we provided complete stone-free condition through Ultra-Mini Percutaneous Hepatolithotomy (UM-PHL) using urological instruments.Öğe Retrograt intrarenal cerrahi uygulanan erişkin ve çocuk hastaların etkinlik ve sonuçlarının karşılaştırılması(2019) Özkent, Mehmet Serkan; Pişkin, Mehmet MesutTaş hastalığı yüzyıllardan beri biliniyor olmasına rağmen günümüzde yaygınlığı çocuk ve erişkinlerde gittikçe artmaktadır. Teknolojik gelişmeler, endoskopik aletlerin minyatürizasyonu böbrek taşlarının tedavisinde retrograt intrarenal cerrahinin etkin şekilde kullanımına olanak sağlamıştır. Çocuk hastalarda bu konuda kısıtlı sayıda çalışma vardır. Çalışmamızda, retrograt intrarenal cerrahi ile tedavi edilen çocuk ve erişkin hastalardaki tam taşsızlık oranları ile komplikasyon oranlarını karşılaştırarak retrograt intrarenal cerrahinin çocuk hastalardaki etkinliğini ve güvenirliğini değerlendirmeyi amaçladık. MATERYAL-METOD: Çalışmamızda 01.01.2010 ile 01.03.2018 tarihleri arasında böbrek taşı tanısı konulup retrograt intrarenal cerrahi ile tedavi edilen hastaların dosyaları incelendi. Hastalar çocuk (18 yaş altı) (grup 1) ve erişkin (18 yaş ve üzeri) (grup2) yaş gruplarına ayrıldı. Gruplar; taş yükü, taş boyutu, taş lokalizasyonu, operasyon süresi, üreteral erişim kılıf kullanımı, intraoperatif komplikasyon oranları, tam taşsızlık oranları, postoperatif komplikasyon oranları, hastane yatış süreleri, DJ katater kullanımı açısından karşılaştırıldı. BULGULAR: Grup 1 içerisinde 55 hasta ve grup 2 içerisinde 220 hasta olmak üzere toplam 275 hasta değerlendirilmeye alındı. Hastaların ortalama yaşı 36,5 ± 20,1 (8 ay- 89 yıl) yıl olarak izlendi. Ortalama taş boyutu 14,6 ± 6,7 mm (5-47 mm) idi. Ortalama operasyon süresinin 62,9 ± 24,4 (25-170 dk) dakika (dk) olduğu görüldü. Hastanede yatış süresi 1,9 ± 2,4 (1-15 gün) gün olarak tespit edildi. Her iki grupta taş yükü, taş sayısı (tek-multipl), taş opasitesi, taraf, işlem öncesi hidroüreteronefroz derecesi ve operasyon sürelerinin benzer olduğu tespit edildi. Gruplar arasında ilk seans cerrahi sonrası tam taşsızlık oranları (grup 1 %81,8, grup 2 78,2, p: 0,554) benzer olarak bulundu. Toplam komplikasyon oranı %13,8 (grup 1 %16,4, grup 2 13,2) olup iki grup arasında fark izlenmedi. SONUÇ: Çalışmamızda böbrek taşı olan çocuk hastalarda RIRS'ın etkin ve güvenle kullanılabilecek minimal invazif cerrahi prosedür olduğunu tespit ettik. Alt pol taşı varlığının, artan taş yükünün ve birden fazla taş mevcudiyetinin hem çocuk hem de erişkin hastalar için cerrahi sonrası başarıyı etkileyen en önemli faktörler olduğunu gördük.